The effect of training on the interpretation of ⁹⁹Tc^m-sestambibi myocardial perfusion spet in patients with suspected coronary artery disease

The aim of this study was to examine the effect of a period of concentrated training in nuclear cardiology on the accuracy of reporting 99Tcm-sestamibi (99Tcm-MIBI) single photon emission tomographic (SPET) images. Two visiting cardiologists, with no previous experience in nuclear cardiology, were asked to report blindly 60 99Tcm-MIBI SPET scans after 2 weeks of training in nuclear cardiology. One (observer 2) reported the same scans blindly after 2 months of further training. The results were compared with the assessment made by two experienced nuclear cardiologists and by using kappa statistics. Kappa values for the overall interpretation of the scan (normal or abnormal), segmental analysis (normal, ischaemic, fixed or mixed) and the three arterial territories were 0.7, 0.58 and 0.67 respectively. Following 2 months of further intensive training of observer 2, the kappa values were 0.857, 0.78 and 0.91 respectively. The difference between the two readings of observer 2 was significantly different for the segmental analysis (P < 0.001) and arterial territories (P = 0.006) but it did not reach statistical significance for the overall interpretation (P = 0.7). Thus, cardiologists without previous interpretation skills in nuclear cardiology required about 2 months of intensive training to achieve good accuracy in the interpretation of 99Tcm-MIBI SPET images. Accordingly, these techniques can be established in centres other than tertiary sites. © 1997 Chapman ami Hall Ltd.